Effect of the Hybrid Assistive Limb on the Gait Pattern for Cerebral Palsy.

Journal: Medicina (Kaunas, Lithuania)
PMID:

Abstract

Cerebral palsy (CP) is the most frequent childhood motor disability. Achieving ambulation or standing in children with CP has been a major goal of physical therapy. Recently, robot-assisted gait training using the Hybrid Assistive Limb (HAL) has been effective in improving walking ability in patients with CP. However, previous studies have not examined in detail the changes in gait pattern after HAL training for patients with spastic CP, including gait symmetry. This study aimed to evaluate the immediate effect of HAL training on the walking ability and the changes in gait pattern and gait symmetry in patients with spastic CP. : We recruited 19 patients with spastic CP (13 male and six female; mean age, 15.7 years). Functional ambulation was assessed using the 10-Meter Walk Test and gait analysis in the sagittal plane before and after a single 20-min HAL intervention session. The walking speed and stride length significantly increased after HAL intervention compared to the pre-intervention values. Two-dimensional gait analysis showed improvement in equinus gait, increase in the flexion angle of the swing phase in the knee and hip joints, and improvement in gait symmetry. Immediate improvements in the walking ability and gait pattern were noted after HAL training in patients with spastic CP. The symmetry of the joint angle of the lower limb, including the trunk, accounts for the improvement in walking ability after HAL therapy.

Authors

  • Yuki Mataki
    Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Japan.
  • Hirotaka Mutsuzaki
    Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Japan; Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Japan.
  • Hiroshi Kamada
    Department of Orthopaedic Surgery, University of Tsukuba (Tsukuba Pediatric Orthopaedic Group), Tsukuba, Japan.
  • Ryoko Takeuchi
    Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences (Tsukuba Pediatric Orthopaedic Group), Ami, Japan.
  • Shogo Nakagawa
    Department of Orthopaedic Surgery, University of Tsukuba (Tsukuba Pediatric Orthopaedic Group), Tsukuba, Japan.
  • Kenichi Yoshikawa
    Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami Ibaraki, Japan.
  • Kazushi Takahashi
    Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Japan.
  • Mayumi Kuroda
    Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan.
  • Nobuaki Iwasaki
    Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Japan; Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Japan.
  • Masashi Yamazaki
    Department of Orthopaedic Surgery, University of Tsukuba (Tsukuba Pediatric Orthopaedic Group), Tsukuba, Japan.